Active NPI
John R Olson, MD
- Anatomic Pathology & Clinical Pathology Physician
- Columbia, TN
National Provider Identifier
1366488322
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anatomic Pathology & Clinical Pathology Physician
- License
- MD7578
- Practice address
- 1602 Hatcher LN
Columbia, TN 38401-4827 - Phone
- (931) 388-0777
- Fax
- (931) 388-1548
- NPI assigned
- Jun 20, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anatomic Pathology & Clinical Pathology Physician | 207ZP0102X | MD7578 | TN | Primary |
Addresses
Primary practice location
1602 Hatcher LN
Columbia, TN 38401-4827
Mailing address
1602 Hatcher LN
Columbia, TN 38401-4827
Phone (931) 388-0777
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3031067 | Other | BLUE CARE/TN CARE | |
| 200288300 | Medicaid | IN | |
| 3403473 | Medicaid | TN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20110822000447 | TN | Order and Referring Only - Pathology | 8224011903 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD7578 | TN | MD | Anatomic Pathology & Clinical Pathology Physician |
| 7578 | TN | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ferrell, Olson, Pearson & Bramlett | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Specialist
- Columbia, TN
- NPI 1235476482
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150761600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1305849600000",
"number": "1366488322",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1602 HATCHER LN",
"city": "COLUMBIA",
"state": "TN",
"postal_code": "384014827",
"telephone_number": "931-388-0777",
"fax_number": "931-388-1548"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1602 HATCHER LN",
"city": "COLUMBIA",
"state": "TN",
"postal_code": "384014827",
"telephone_number": "931-388-0777",
"fax_number": "931-388-1548"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OLSON",
"first_name": "JOHN",
"middle_name": "R",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-20",
"last_updated": "2011-05-20",
"status": "A"
},
"taxonomies": [
{
"code": "207ZP0102X",
"taxonomy_group": "",
"desc": "Pathology, Anatomic Pathology & Clinical Pathology",
"state": "TN",
"license": "MD7578",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CARE/TN CARE",
"identifier": "3031067",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "200288300",
"state": "IN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3403473",
"state": "TN"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Columbia, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.